Perclose, Inc. of Menlo Park, Calif. has recently disclosed a percutaneous vascular closure device which it designates by the trademark PROSTAR. The PROSTAR device is arranged to be inserted through a percutaneous puncture into a artery to seal the opening in the arterial wall. To that end the PROSTAR device inserts plural needles having sutures secured thereto through the percutaneous puncture and into the interior of the artery. The needles are then drawn from the interior of the artery through the arterial wall portion surrounding the puncture and out through the puncture tract, where they are grasped to pull the associated sutures out of the puncture tract. The extending portions of the sutures are knotted within the puncture tract and the knots are pushed into the tract by an associated device, designated as the PROSTAR knot pusher, so that the knots are closely adjacent or abutting the exterior of the artery wall.. This action ostensibly seals the opening in the artery wall.
It is believed that there may be some blood seepage out of the puncture tract when using the PROSTAR system.
In U.S. Pat. No. 5,282,827, assigned to Kensey Nash Corporation, the assignee of this invention, there is disclosed and claimed a closure device for sealing percutaneous arterial punctures. The closure of that patent, which is designated by the trademark HPCD, basically comprise a rigid anchor, a compressed collagen plug, and a thin filament connecting the two in a pulley-like arrangement. The HPCD closure is positioned within the percutaneous puncture by a deployment instrument which is extended through an introducer sheath. The deployment instrument includes a carrier to eject the anchor through the puncture. The anchor is then drawn against the free end of the introducer. The instrument and introducer are then withdrawn together to pull the anchor against the tissue contiguous with the puncture inside the artery. Further withdrawal draws the plug out of the carrier into the puncture tract, whereupon the plug moves with respect to the anchor into engagement with tissue in the puncture tract outside of artery wall to seal the puncture or incision. A tensioning device limits the force applied to the filament. The carrier also includes a tamper which is used to mechanically deform the plug within the tract. Once positioned hemostasis occurs rapidly, e.g., blood clots within the collagen plug, thereby locking the closure in place.
While the HPCD closure has proven very effective for its intended purposes, there may also be some slight seepage of blood from the puncture tract in some cases, albeit the seepage is less than with the PROSTAR system since the HPCD closure makes use of blood clotting within its collagen plug to effect rapid hemostasis. The slight seepage of blood from the puncture tract in some cases when using the HPCD closure may be from the interior of artery or from small capillaries contiguous with the puncture tract.